Development and validation of the TOCO–TURBT tool: a summative assessment tool that measures surgical competency in transurethral resection of bladder tumour

Development and validation of the TOCO–TURBT tool: a summative assessment tool that measures...
Vries, Anna; Muijtjens, Arno.; Genugten, Hilde; Hendrikx, Ad.; Koldewijn, Evert; Schout, Barbara; Vleuten, Cees; Wagner, Cordula; Tjiam, Irene; Merriënboer, Jeroen
2018-06-05 00:00:00
Background The current shift towards competency-based residency training has increased the need for objective assessment of skills. In this study, we developed and validated an assessment tool that measures technical and non-technical competency in transurethral resection of bladder tumour (TURBT). Methods The ‘Test Objective Competency’ (TOCO)–TURBT tool was designed by means of cognitive task analysis (CTA), which included expert consensus. The tool consists of 51 items, divided into 3 phases: preparatory (n = 15), procedural (n = 21), and completion (n = 15). For validation of the TOCO–TURBT tool, 2 TURBT procedures were performed and videotaped by 25 urologists and 51 residents in a simulated setting. The participants’ degree of competence was assessed by a panel of eight independent expert urologists using the TOCO–TURBT tool. Each procedure was assessed by two raters. Feasibility, acceptability and content validity were evaluated by means of a quantitative cross-sectional survey. Regression analyses were performed to assess the strength of the relation between experience and test scores (construct validity). Reli- ability was analysed by generalizability theory. Results The majority of assessors and urologists indicated the TOCO–TURBT tool to be a valid assessment of competency and would support the implementation of the TOCO–TURBT assessment as
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Development and validation of the TOCO–TURBT tool: a summative assessment tool that measures surgical competency in transurethral resection of bladder tumour

Abstract

Background The current shift towards competency-based residency training has increased the need for objective assessment of skills. In this study, we developed and validated an assessment tool that measures technical and non-technical competency in transurethral resection of bladder tumour (TURBT). Methods The ‘Test Objective Competency’ (TOCO)–TURBT tool was designed by means of cognitive task analysis (CTA), which included expert consensus. The tool consists of 51 items, divided into 3 phases: preparatory (n = 15), procedural (n = 21), and completion (n = 15). For validation of the TOCO–TURBT tool, 2 TURBT procedures were performed and videotaped by 25 urologists and 51 residents in a simulated setting. The participants’ degree of competence was assessed by a panel of eight independent expert urologists using the TOCO–TURBT tool. Each procedure was assessed by two raters. Feasibility, acceptability and content validity were evaluated by means of a quantitative cross-sectional survey. Regression analyses were performed to assess the strength of the relation between experience and test scores (construct validity). Reli- ability was analysed by generalizability theory. Results The majority of assessors and urologists indicated the TOCO–TURBT tool to be a valid assessment of competency and would support the implementation of the TOCO–TURBT assessment as